Kidney Week

Abstract: FR-PO1183

GFR Trends with Tocilizumab Therapy for Chronic Antibody-Mediated Rejection in Kidney Transplant Recipients: A Single-Center Experience

Session Information

• Transplantation: Clinical - Rejection, Biomarkers, and Pharmacology
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Inkong, Pitchamon, Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, United States

Pitchamon Inkong, MD

• Bunnapradist, Suphamai, Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Suphamai Bunnapradist, MD

• Qureshi, Ahad A., Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Ahad A. Qureshi, MD, MPH

• Pham, Phuong-Thu T., Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Phuong-Thu T. Pham, MD, FASN

• Sethi, Supreet, Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Supreet Sethi, MD

• Lum, Erik Lawrence, Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, United States

Erik Lawrence Lum, MD, FASN

Background

Chronic antibody mediated rejection (cABMR) is a leading cause of allograft loss in kidney transplant recipients. Standard of care treatment with IVIG and rituximab has limited efficay. Tocilizumab, an IL-6 inhibitor, has been shown to stabilize renal function in patients with cABMR and reduce donor-specific antibody levels. Data on following discontinuation of tocilizumab is limited.

Methods

This was a single center retrospective observational study which looked at adult kidney transplant recipients diagnosed with cABMR who were treated with tocilizumab therapy between January 2018 to October 2024. The degree of inflammation on kidney biopsy, tocilizumab exposure, renal allograft function pre-, current, and post-therapy were assessed.

Results

A total of 19 patients were identified with a median time to treatment from kidney transplantation of 30 months. Five patients received minimal therapy, defined as < 6 months due to medication side effects. The remaining 14 patients received > 6 months of therapy and were analyzed. A median eGFR declined 10.5 ml/min in the year prior to initiating tocilizumab with stabilization of eGFR while on therapy. Less than 50% of treated patients experienced a greater than 50% decrease in their antibodies. After stopping therapy patients experienced a median decline in eFGR by of 10 ml/min over the ensuing year.

Conclusion

Tocilizumab therapy stabilizes renal function in kidney transplant patients experiencing cABMR. Cessation of tocilzumab results in a decline in renal function and prolonged treatment should be considered to preserve renal function.

Acknowledgment

The multidisciplinary kidney transplant team at UCLA

Table 1 Demographics data

* Mean (±SD) ** Median (IQR)

Figure 1 GFR trends throughout course for patients pre, during, and post tocilizumab